How Important Are Cancer Screening Exams?

Screening tests help find cancer before the symptoms appear.


“Late stage cancers often lack effective treatment options. Survival rates increase significantly when cancer is identified at early stages, as the tumor can be surgically removed or treated with milder drug regimens”

1.Huang, A. C. et al. Nature 545, 60–65 (2017).

2.Prigerson, H. G. et al. . JAMA Oncol. 1, 778 (2015).

3.World Health Organization. Guide to Early Cancer Diagnosis. (2017)


We are lucky to live in a time where prevention and early detection of several types of cancers is a priority in healthcare and the appropriate screening tests are easily available. These recommended cancer screening tests look for cancer before a person has any symptoms and are targeted to help make it easier to treat the disease successfully and improve your quality of life. Whether you have had cancer or not, there are screening tests that should be part of your healthcare routine. This is especially true if you have a close relative as a cancer patient or a family history of cancer.


CHOOSING THE RIGHT SCREENING FOR YOU:


Screening recommendations vary for those with average risk and high risk. Here are the ones that apply to average-risk women and men. Individuals at increased risk may need different tests or may need to be tested more often. The following is a list of standardized screening guidelines from accredited organizations including American Cancer Society and National Cancer Institute.

  • Breast cancer screenings- Mammograms.

  • Cervical cancer screenings – A Pap test is used to screen for cervical cancer.

  • Colon cancer screenings – colonoscopy

  • Prostate cancer screenings – PSA levels in the blood

  • Lung cancer screenings – low dose CT scan

Screening guidelines usually specify who must be screened and when screening must begin.. Cancer screening is a choice that an individual and their doctor must make together, depending on their overall health, individual cancer risk, and individual preferences. There aren't efficient screening procedures for every type of cancer. It is important that you understand your individual hereditary risk of having cancer. People with a significant family history of cancer or who have a genetic mutation that raises cancer risk, such as the BRCA mutation, require an individualized screening regimen that may vary from general guidelines.



For Breast Cancer


  • Age 25 - 39: Get a clinical breast exam every one to three years. Also, learn how to do a self-breast exam correctly and regularly (Your primary care doctor can guide you here).

  • Age 40 & Older: Get a mammogram and clinical breast exam done every year.



For Cervical Cancer


  • Age 25 - 29: The HPV test every five years (preferred) or a pap test every 3 years is recommended.

  • Age 30 - 65: Get an HPV test, with or without a Pap test, every five years (preferred) or get a Pap test every three years.

  • Age 65 or Older: You may not need additional exams if you’ve had no unusual Pap or HPV test results in the past 10 years. However, it is always better to discuss this with your doctor.



For Colon & Rectal Cancers


According to recent research, it is ​​now advised that men and women at average risk for colorectal cancer should get a screening colonoscopy every 10 years regardless of race. It is also important that you be familiar with your body. That way you’ll notice changes, like bleeding or unusual bowel movements which may require you to get screened earlier.

  • Age 45 & older: Get a screening colonoscopy every 10 years.

Alternative exams to a screening colonoscopy include virtual colonoscopy and stool tests but these are not considered the standard of care. Talk to your primary care physician about these tests before you decide.


For Lung Cancer


You should get screened if you:

  • Are presently a smoker or have stopped smoking in the past 15 years.

  • Have smoked for at least 20 years (for instance, single pack each day for 20 years or double pack each day for 10 years).


Here is the screening schedule:

  • Age 50 - 80: Low-dose computerized tomography (CT scan) every year.

For Prostate Cancer


Males should follow the guidelines for prostate cancer screening outlined below:

Age 45

Discuss screening risks and benefits with a health care provider.

  • Get a PSA blood test if you want to get examined.

  • Strongly consider the digital rectal exam, if you choose to be screened.

  • Keep testing according to your previous test findings.


Age 75 or Older

  • Your doctor can advise you on whether or not you should continue with prostate cancer screening.

There are other screening tests that are recommended based on several risk factors including for skin cancers, head & neck cancers, liver cancers etc. As mentioned previously, for high-risk individuals with family history, genetic susceptibility or history of prior cancers, the screening recommendations are different. You must talk to your primary care physician or cancer care team and make sure you follow the screening guidelines that are appropriate for you.

Cancer screening is not perfect and comes with benefits and risks but the benefits far outweigh any risks including false positive or false negative results, over diagnosis and rare side effects. The obvious benefits, of course, are saving lives, making treatment more effective and improving the quality of life. There are certain guidelines that are applicable to reducing the risk of nearly all cancers in the general population including:

  • Regular exercise and a healthy diet to manage your weight because being overweight can increase your risk of developing certain types of cancer. Losing even a small amount of weight, like 10% of your body weight, can help reduce your risk and improve your overall health.

  • Avoiding cigarette smoking which has been linked to malignancies of the lungs, bladder, esophagus, kidney, pancreas, and head and neck.

  • Decreasing and if possible, avoiding alcohol consumption. The cumulative lifetime alcohol consumption is a significant predictor of future risk of breast, esophageal, liver, colorectal, stomach, oral, and some head and neck cancers.

  • Protecting yourself from UV rays to lower your risk of developing skin cancer.

A cancer diagnosis can be overwhelming, but knowing is the necessary first step toward the treatment you need. If your primary care physician sees something concerning during a screening, they will guide you through the next steps. Depending on the type of cancer, you might see an oncologist, a surgeon, or another medical specialist. No matter what type of physician you see, they will work with you to create an individualized treatment plan and guide you through every step of treatment and recovery.

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Reason to Hope

There is new research from Brigham and Women’s Hospital that indicates a Western-style diet that is rich in red and processed meat, sugar and refined grains/carbohydrates is tied to higher risk of colorectal cancer through the intestinal microbiota.  Gastroenterology, 2022;DOI:10.1053/j.gastro.2022.06.054